department of paediatrics how-htar seminar

PAEDIATRIC DEPARTMENTHospital Tengku Ampuan Rahimah, Klang

INTRODUCTION Patients from neonatal age group to 12 years Neonatal wards – below age of 1 month Paediatric wards/Isolation/PHDU- from age of

1 month to 12 years

WARD FUNCTION NO OF BEDS6A SCN 206B GENERAL

PEADIATRIC WARD

36

6C SCN 426D NICU 32PHDU PICU 67D ISOLATION

WARD10

6C

7D

WORKLOAD BOR of all wards exceeded 80%. Wad 6B-General Paediatric Ward BOR 94.8-

120%. Now 200% BOR Wad 6C (SCN) - 110.76% 6D(NICU) - 91.5%.

CLINIC MONDAYS TO FRIDAYS

About 2,810 patients were seen in 2008.

OTHER ACTIVITIES

CHALLENGES Crowded wards. Increasing bed occupancy rates Shortage of staffs Lack of subspecialists

FUTURE NEW MATERNITY AND CHILD COMPLEX

HOUSEMANSHIP IN PAEDIATRICS 4 months Tagging period- observe and supervised for

procedures and clerking of patients.

5pm to 10.30pm on weekdays 8am to 5.30pm on weekends and PH

Working hours – 7a.m to 5p.m. Morning and afternoon rounds

Calls. 8 houseman on call Night rounds Rotation through all wards except PICU Labour room cover Newborn screening

CME Houseman teaching once a week Journal club meetings Grand ward round weekly Monthly mortality meeting Perinatal meeting

PROCEDURAL SKILLS Blood sampling Peripheral venous sampling Exchange transfusion Catherisation

MANAGEMENT SKILLS 6C/6D

Gestational age assessment Fluid requirement Feeding - amount, method Recognize an ill infant

COMMON ADMISSIONS TO 6C/6D

Presumed sepsis Neonatal jaundice Hypoglycemia Infants of diabetic mothers Newborn with respiratory distress Preterm infants

MANAGEMENT SKILLS WARD 7D Hydration status Shock Oral rehydration Common admissions

AGE Dengue fever and DHF

MANAGEMENT SKILLS IN 6B Common admissions

Respiratory infections Asthma Febrile fits Acute glomerulonephritis/nephrotic syndrome Poisons

ASSESSMENT

Throughout the posting Attitude Knowledge Skills

Viva NRP Log books

ISSUES WITH HOUSEMAN Strict and satisfactory hand washing is a

moral obligation Sharps disposal Punctuality Proper usage of equipment Be contactable Follow guidelines in each ward

Summaries within 48 hours Knowledge of patients in wards Acquiring knowledge Clinical practise guidelines Entries in patient notes improper and

incomplete Soft skills

FINALLY Ensure time is utilised effectively Clear doubts as they arise Take pride in your work Work as a team Acquire basic skills and knowledge Houseman are the eyes, ears and our hands

when we are not there Learning has just begun